Tele-health in Asia : a systematic review

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Background: Telehealth continues to develop rapidly in Asia and information on its applications, technologies, costs and benefits is becoming of great importance for the decision makers in health care. This t chnique has been used and reported in the western industrialized block, such as North America, Australia and Europe, where a significant pool of literature has emerged on its success and limitations. However proposing the same technique for health care delivery in the Eastern side of the globe where majority of the population resides, requires evidence. The Western literature though in good volume cannot entirely be generalized to Asian region due to its diversity and geography. Relatively few studies have been able to collect the data systematically, which is required to provide an unambiguous demonstration of the value of telehealth applications, developing countries in general and Asian countries in particular. Objectives: The main objective of this study was to conduct a thorough and current state of the literature review of telehealth applications, with specific emphasis on telehealth in Asia Methodology: This Systematic review will follow Cochrane style methodology from 1997 to 2007 related to any sort of telehealth applications involving Asian countries. The Review was divided in 5 stages; stage 1, setting selection criteria for studies and conducting literature search, stage 2 reviews of abstracts, stage 3, reviews of complete articles, stage 4, quality assessments of selected studies and stage 5 syntheses of data and analysis. Results: Out of the 1503 abstracts retrieved, 109 articles were selected for the final review. The overall finding of the review gives us an optimistic picture of different telehealth initiatives in Asian health care settings, with increasing trends of telehealth studies. Studies that have emerged on telehealth applications are useful but lack good quality studies and in some cases the generalizability is limited to specific settings. Store and forward modalities tend to be favored more by developing part of the Asian continent, while a mix element of use of both modalities was found in developed countries i.e. store and forward and real time. ISDN (Integrated Services Digital Neworks) and Plain old telephone lines (POTs) with few satellite connections for remote areas are the preferred connections used by the former countries, while Broad Band connections, Wireless technologies and ISDN were choice of connections for the latter. Considerable development is needed on making a broader telehealth (e-health) policy incorporated in countries e-government policies. Conclusion The overall findings of the review give an optimistic picture of different telehealth initiatives in health care in Asia. Focusing on telehealth policy and telehealth application will not be a shift in priorities of the developing countries; rather it will be a change in the methods of management for those priority problems faced by the developing countries of Asia and the World.

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